Acute tubular necrosis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Causes

Ischemic Acute Tubular Necrosis

Renal hypoperfusion is the major cause of ischemic ATN. A decrease in perfusion pressure to the extent that renal protective mechanisms fail to maintain adequate tissue perfusion leads to ATP depletion and cell necrosis. In parallel, disruption of renal protective mechanisms may also lead to ATN. Some etiologies associated with ischemic ATN include:

Hypotension
Sepsis
Cardiogenic shock
Renal vein thrombosis
ACE inhibitors
Angiotensin receptor blockers
NSAIDs
IV contrast

Toxic Acute Tubular Necrosis

ATN can occur due to direct or indirect tubular cell cytotoxicity secondary to medications or substance exposures. Some causes of toxic ATN include:

Myoglobinuria
Aminoglycosides^[1]
Cephalothin^[2]
Bisphosphonates^[3]
Cisplatin^[4]
Tenofovir^[5]
Amphotericin B^[6]
Lithium^[6]
Mannitol^[6]
Foscarnet^[6]
Cocaine^[6]
Pentamidine^[6]
Sucrose^[6]
Streptozocin^[6]

References

↑ Erdem A, Gündoğan NU, Usubütün A, Kilinç K, Erdem SR, Kara A; et al. (2000). "The protective effect of taurine against gentamicin-induced acute tubular necrosis in rats". Nephrol Dial Transplant. 15 (8): 1175–82. PMID 10910441.
↑ Bobrow SN, Jaffe E, Young RC (1972). "Anuria and acute tubular necrosis associated with gentamicin and cephalothin". JAMA. 222 (12): 1546–7. PMID 4678426.
↑ Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D (2003). "Short-term, high-dose pamidronate-induced acute tubular necrosis: the postulated mechanisms of bisphosphonate nephrotoxicity". Am J Kidney Dis. 41 (5): E18. PMID 12778436.
↑ Faubel S, Ljubanovic D, Reznikov L, Somerset H, Dinarello CA, Edelstein CL (2004). "Caspase-1-deficient mice are protected against cisplatin-induced apoptosis and acute tubular necrosis". Kidney Int. 66 (6): 2202–13. doi:10.1111/j.1523-1755.2004.66010.x. PMID 15569309‎ Check |pmid= value (help).
↑ Herlitz LC, Mohan S, Stokes MB, Radhakrishnan J, D'Agati VD, Markowitz GS (2010). "Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities". Kidney Int. 78 (11): 1171–7. doi:10.1038/ki.2010.318. PMID 20811330.
↑ ^6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 ^6.6 ^6.7 Guo X, Nzerue C (2002). "How to prevent, recognize, and treat drug-induced nephrotoxicity". Cleve Clin J Med. 69 (4): 289–90, 293–4, 296-7 passim. PMID 11996200.

Template:WikiDoc Sources

[pmid10910441-1] Erdem A, Gündoğan NU, Usubütün A, Kilinç K, Erdem SR, Kara A; et al. (2000). "The protective effect of taurine against gentamicin-induced acute tubular necrosis in rats". Nephrol Dial Transplant. 15 (8): 1175–82. PMID 10910441.

[pmid4678426-2] Bobrow SN, Jaffe E, Young RC (1972). "Anuria and acute tubular necrosis associated with gentamicin and cephalothin". JAMA. 222 (12): 1546–7. PMID 4678426.

[pmid12778436-3] Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D (2003). "Short-term, high-dose pamidronate-induced acute tubular necrosis: the postulated mechanisms of bisphosphonate nephrotoxicity". Am J Kidney Dis. 41 (5): E18. PMID 12778436.

[pmid15569309‎-4] Faubel S, Ljubanovic D, Reznikov L, Somerset H, Dinarello CA, Edelstein CL (2004). "Caspase-1-deficient mice are protected against cisplatin-induced apoptosis and acute tubular necrosis". Kidney Int. 66 (6): 2202–13. doi:10.1111/j.1523-1755.2004.66010.x. PMID 15569309‎ Check |pmid= value (help).

[pmid20811330-5] Herlitz LC, Mohan S, Stokes MB, Radhakrishnan J, D'Agati VD, Markowitz GS (2010). "Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities". Kidney Int. 78 (11): 1171–7. doi:10.1038/ki.2010.318. PMID 20811330.

[pmid11996200-6] 6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 ^6.6 ^6.7 Guo X, Nzerue C (2002). "How to prevent, recognize, and treat drug-induced nephrotoxicity". Cleve Clin J Med. 69 (4): 289–90, 293–4, 296-7 passim. PMID 11996200.

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